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Writer's picturePhilip Niño Tan-Gatue

Pre-Op Jitters? Acupuncture Helps!

I recall the story of a famous surgeon. He was a reputed miracle worker whose talent with the scalpel was unparalleled. Countless lives were saved under his care in the operating room.

Imagine my surprise, then, when he once told my father (who then obviously told me the story later on), that when the time came for the surgeon to go under the knife, the surgeon was scared out of his wits.

Irony aside, we have to acknowledge the fact that even the greatest surgeons are human. It is also but human to fear something as potentially traumatic as being rendered helpless and unconscious followed by having someone play slice and dice with your innards. Yes, even the most battled hardened veteran would feel fear and anxiety.

So how can acupuncture help?

A recent study in the Journal of Alternative and Complementary Med reports the research done by Acar et al with regards to using the ear point Yintang can reduce anxiety. Here is the abstract:

Abstract Objectives: The aim of this study was to investigate the effect of ear-press needle acupuncture on Yintang point for preoperative anxiety. Design: This was a prospective, randomized, single-blind, controlled study. Settings/location: The study setting was the Department of Anesthesiology in Ankara Training and Research Hospital of Ministry of Health, Ankara, Turkey. Subjects: The study comprised 52 adult surgical patients. Interventions: A single, 20-minute session of single-point acupuncture was applied on Yintang (acupuncture group) or sham point (sham acupuncture group). Outcome measures: The efficacy of acupuncture was evaluated by means of the changes in bispectral index (BIS) and STAI (State-Trait Anxiety Index). Results: BIS values in the acupuncture group were significantly lower than in the sham group in all time intervals (p<0.0042). BIS values were lower than baseline in the study group during the entire study period (p<0.0004) while no such effect has been observed in the sham group (p>0.0004). Mean values of state anxiety (STAI-S) decreased after acupuncture in the study group (p=0,018), while no change was observed in trait anxiety (STAI-T) (p=0.156). Patients of the sham group showed no change in both parameters (p=0.387 and p=0,116). Conclusions: Ear-press needle acupuncture on Yintang point reduces preoperative anxiety in adult surgical patients.

What are the salient points of this article? First, it uses ear-press needles, which are decidedly less invasive than full body acupuncture. Second, it uses only one point, which may be better for patients who are already quite admittedly anxious. Third, it compares stimulation of a real point vs actual needling of a sham point as control, and we see that the results differ significantly between real needling and sham needling.

Let’s go on to analyze the parameters used for assessing the results. The two methods used were Bispectral Index and State-Trait Anxiety Inventory. Both are much better than just asking the patient “so how do you feel”?

Bispectral Index, I am told by some anesthesiologist friends, uses a device that basically indicates how “deep” into the anesthesia a patient is. The lower the number, the better. 100 is fully awake, and around 50 is good enough for general anesthesia.

The State-Trait Anxiety Inventory is of more significance here. It is a psychological inventory that attempts to measure both anxiety about an event, or trait anxiety. Scores range from 20-60 and a higher number means more anxiety.

The study states that patients with true acupuncture had lower scores in the STAI, which leads to the conclusion that acupuncture does help with pre-op jitters.

References:

1. Acar, et al. Acupuncture on Yintang Point Decreases Perioperative Anxiety. J Altern Complement Med. 2012 Dec 27 [Epub ahead of print]

2. SR Tilton (2008). “Review of the State-Trait Anxiety Inventory (STAI)”. NewsNotes. Retrieved 2013-01-30

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